Wound Care Certification Exam Wound Care Certification Pressure Injury Prevention 2 — Questions and Answers
Question 1: A patient with a Stage 3 pressure injury has a BMI of 16.2 and serum albumin of 2.1 g/dL. Which nutritional intervention is MOST appropriate to support wound healing?
- Restrict protein to 0.8 g/kg/day to prevent renal strain
- Provide 1.25–1.5 g/kg/day protein with caloric supplementation (Correct answer)
- Initiate parenteral nutrition immediately regardless of GI function
- Supplement with vitamin C only and recheck albumin in 4 weeks
Correct answer: Provide 1.25–1.5 g/kg/day protein with caloric supplementation
Malnourished patients with pressure injuries require 1.25–1.5 g/kg/day protein and adequate calories to support tissue repair.
Question 2: Which Braden Scale subscale directly measures the patient's ability to change and control body position?
- Moisture
- Activity
- Mobility (Correct answer)
- Friction and Shear
Correct answer: Mobility
The Mobility subscale assesses the patient's ability to change and control their body position independently.
Question 3: A critically ill patient in the ICU is placed on a vasopressor. How does this medication increase pressure injury risk?
- It increases urine output, causing moisture-related skin breakdown
- It causes peripheral vasoconstriction, reducing tissue perfusion to bony prominences (Correct answer)
- It raises core body temperature, accelerating skin breakdown
- It causes agitation, increasing friction and shear forces
Correct answer: It causes peripheral vasoconstriction, reducing tissue perfusion to bony prominences
Vasopressors cause peripheral vasoconstriction, which reduces blood flow to skin over bony prominences and increases ischemia risk.
Question 4: Which support surface feature is MOST important for a patient with a pressure injury on the sacrum who is fully dependent for repositioning?
- Low air-loss capability to manage moisture
- Alternating pressure to cyclically relieve pressure (Correct answer)
- Lateral rotation to prevent pulmonary complications
- High-density foam for cost-effective immobility support
Correct answer: Alternating pressure to cyclically relieve pressure
Alternating pressure surfaces cyclically relieve pressure and are recommended for high-risk patients who cannot reposition themselves.
Question 5: A nurse notices a dark purple discoloration on an intact heel of a patient admitted 6 hours ago. The area is firm and painful. This finding is BEST classified as:
- Stage 1 pressure injury
- Stage 2 pressure injury
- Deep tissue pressure injury (DTPI) (Correct answer)
- Unstageable pressure injury
Correct answer: Deep tissue pressure injury (DTPI)
Deep tissue pressure injury presents as intact skin with non-blanchable dark purple or maroon discoloration indicating injury to underlying soft tissue.
Question 6: When repositioning a patient to prevent pressure injury, which technique BEST reduces shear forces?
- Elevating the head of bed to 90 degrees before turning
- Using a draw sheet or friction-reducing slide sheet to move the patient (Correct answer)
- Rolling the patient directly across the mattress surface
- Asking the patient to push with their heels during repositioning
Correct answer: Using a draw sheet or friction-reducing slide sheet to move the patient
Friction-reducing slide sheets minimize the shear and friction forces applied to skin during repositioning.
Question 7: According to NPUAP/EPUAP guidelines, what is the MAXIMUM recommended head-of-bed elevation for patients at risk for pressure injuries, unless medically contraindicated?
- 15 degrees
- 30 degrees (Correct answer)
- 45 degrees
- 60 degrees
Correct answer: 30 degrees
The head of bed should be maintained at 30 degrees or less to minimize shear forces on the sacrum and coccyx.
Wound Care Certification Exam Wound Care Certification Pressure Injury Prevention 2
A patient with a Stage 3 pressure injury has a BMI of 16.2 and serum albumin of 2.1 g/dL.
Which nutritional intervention is MOST appropriate to support wound healing?